Breed Matters: What Every Veterinarian Should Know About High-Risk Dogs for Recurrent Otitis

Why do Cocker Spaniels, Bulldogs and Retrievers keep returning with otitis despite appropriate treatment?

It's rarely because the previous treatment failed.

More often, these breeds possess a combination of risk factors that increases their likelihood of developing recurrent otitis externa. Large epidemiological studies have shown that breed significantly influences the risk of otitis, while clinical evidence suggests that factors such as underlying allergic skin disease, chronic inflammation, and changes in the ear canal environment contribute to repeated episodes^1,2,3.

For the practicing veterinarian, recognising breed-associated risk is just as important as selecting the right ear medication. Identifying susceptible patients early allows clinicians to investigate underlying disease, implement preventive strategies, and intervene before acute otitis progresses to chronic or end-stage ear disease.

Breed Is a Recognised Risk Factor

A large UK VetCompass study evaluating more than 900,000 dogs reported that approximately 7.3% of dogs were diagnosed with otitis externa annually. However, the risk was not evenly distributed across breeds².

Breeds identified with a significantly increased risk included:

• English Cocker Spaniel
• Cockapoo
• Golden Retriever
• Labrador Retriever
• Basset Hound
• Beagle
• Chinese Shar-Pei
• Labradoodle

These findings highlight that breed should be considered an important clinical risk factor whenever a dog presents with otitis.

What to Watch for in High-Risk Breeds

Although recurrent otitis is a multifactorial disease, certain breeds consistently present with patterns that should alert clinicians to investigate beyond the current infection.

Cocker Spaniels

English Cocker Spaniels are consistently recognised among the breeds most frequently affected by chronic and recurrent otitis^1,2.

When a Cocker Spaniel presents with repeated ear infections, clinicians should anticipate a greater likelihood of disease recurrence and investigate for underlying primary causes, particularly allergic skin disease. Rather than repeatedly prescribing empirical therapy, routine cytology, regular re-evaluation and long-term management planning are often required.

Retrievers

Golden Retrievers and Labrador Retrievers are also overrepresented among dogs with otitis externa and are commonly affected by canine atopic dermatitis^2,3.

For these breeds, recurrent otitis should prompt a thorough dermatological examination. Look for concurrent signs such as:

• Paw licking
• Facial rubbing
• Generalised pruritus
• Ventral erythema
• Seasonal itching

Managing the underlying allergy is often as important as treating the secondary bacterial or yeast infection.

Bulldogs

English Bulldogs frequently present with recurrent skin disease alongside otitis^2,3.

Repeated ear infections in Bulldogs should not be viewed as isolated events. Instead, they should prompt assessment for concurrent dermatological disease and chronic inflammatory changes. Early intervention may reduce progression to irreversible ear canal pathology.

Other High-Risk Breeds

Several additional breeds with increased susceptibility to otitis externa, include:

• Cockapoos
• Basset Hounds
• Beagles
• Chinese Shar-Peis
• Labradoodles

These breeds benefit from proactive ear health monitoring, particularly if they have a history of allergic skin disease or previous episodes of otitis².

Breed Is Only One Piece of the Puzzle

Breed increases risk—but it does not cause otitis on its own.

Current evidence suggests that recurrent otitis develops through the interaction of several factors, including:

• Underlying allergic skin disease
• Ear canal inflammation
• Secondary bacterial and yeast overgrowth
• Alterations in the ear microbiome
• Chronic inflammatory changes within the ear canal^1,3

This explains why some dogs from predisposed breeds remain free of otitis, while others develop repeated infections throughout their lives.

Don't Focus Solely on the Ear

When a predisposed breed presents with recurrent otitis, the consultation should extend beyond the ear canal.

Perform a complete dermatological examination and assess for:

• Paw licking
• Facial rubbing
• Recurrent pyoderma
• Ventral or axillary erythema
• Seborrhoea
• Seasonal or non-seasonal pruritus

These findings frequently indicate an underlying allergic condition that is driving the recurrent ear disease^1,3.

Prevention Starts at the First Episode

Repeated inflammation progressively damages the ear canal.

Without appropriate intervention, recurrent episodes may result in:

• Glandular hyperplasia
• Excess cerumen production
• Fibrosis
• Canal stenosis
• Otitis media
• End-stage ear disease¹

For dogs belonging to high-risk breeds, clinicians should adopt a proactive approach that includes:

• Thorough otoscopic examination during routine consultations
• Early investigation of underlying allergic disease
• Ear cytology at the first sign of recurrence
• Appropriate maintenance ear cleaning where indicated
• Regular follow-up examinations
• Prompt management of inflammation before secondary infection develops

Early intervention is more effective than repeatedly treating advanced chronic otitis.

Treat the Patient's Risk—Not Just Today's Infection

The organisms identified on cytology may vary from one episode to another, but the patient's predisposition often remains unchanged.

Repeated antimicrobial therapy alone rarely prevents recurrence if the factors that make the dog susceptible are left unaddressed.

Recognising breed-associated risk enables veterinarians to shift from reactive treatment to long-term disease prevention.

Clinical Pearl

When a Cocker Spaniel, Retriever, Bulldog or another high-risk breed presents with recurrent otitis, don't simply ask:

"Which ear medication should I prescribe?"

Instead ask:

"What underlying factors are making this patient susceptible to repeated ear disease?"

Answering that question early often prevents years of recurrent infections and progression to chronic otitis.

Key Takeaways

Breed is an established risk factor for canine otitis externa. English Cocker Spaniels, Golden Retrievers, Labrador Retrievers, Bulldogs, Cockapoos, Basset Hounds, Beagles, Chinese Shar-Peis and Labradoodles are among the breeds reported to have an increased risk of otitis. Recurrent otitis in these breeds should prompt investigation for underlying allergic skin disease rather than repeated empirical treatment alone. Early cytology, otoscopy and dermatological assessment improve long-term outcomes. Preventive management is more effective than repeatedly treating secondary infections.

References

1. Bajwa J. Canine otitis externa—Treatment and complications. Canadian Veterinary Journal. 2019;60(1):98–101. PMCID: PMC6294027. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6294027/
2. O'Neill DG, Volk AV, Soares T, Church DB, Brodbelt DC, Pegram C. Frequency and predisposing factors for canine otitis externa in the UK: A primary veterinary care epidemiological view. Irish Veterinary Journal. 2021;74:16. DOI: 10.1186/s40575-021-00106-1. Available from: https://irishvetjournal.biomedcentral.com/articles/10.1186/s40575-021-00106-1
3. Ponn PC, Tipold A, Volk AV, et al. Can We Minimize the Risk of Dogs Developing Canine Otitis Externa? Animals (Basel). 2024;14(17):2537. DOI: 10.3390/ani14172537. PMCID: PMC11394639. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11394639/